剖腹产后增强恢复协议:对阿片类药物使用和疼痛感知的影响
Ememobong O Ubom1, Carrie Wang2, Farina Klocksieben2
1Department of Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, PA (Drs Ubom, Flicker, and Diven).
AJOG global reports
|August 30, 2023
概括
手术后增强恢复 (ERAS) 协议显著降低了剖腹产分娩患者的阿片类药物使用和疼痛评分. 这种多模式的疼痛管理方法有效地减少了剖腹产后的阿片类药物处方需求.
科学领域:
- 产科和妇科 产科和妇科
- 疼痛管理 疼痛管理
- 术后恢复 术后恢复
背景情况:
- 在剖腹产后使用阿片类药物很常见,这有助于持续的阿片类药物流行.
- 随着剖腹产率的上升,需要有效的非阿片类药物疼痛管理策略.
- 手术后增强恢复 (ERAS) 协议提供了一种多模式的方法来改善术后恢复.
研究的目的:
- 评估ERAS协议对阿片类药物消费和剖腹产后疼痛控制的影响.
- 评估多模式疼痛管理在减少剖腹产后处方阿片类药物的有效性.
主要方法:
- 一项回顾性队列研究比较了剖腹产前 (n=1425) 和 (n=3478) 实施ERAS协议后的剖腹产患者.
- 关键结局包括总的阿片类药物使用,解药阿片类药物处方和疼痛评分.
- 排除标准适用于患有阿片类药物使用障碍,剖腹产切除术或重大手术并发症的患者.
主要成果:
- 在ERAS实施后,阿片类药物的总使用量显著下降 (中位数为75MME与30MME,P<.001).
- 退院后的阿片类药物处方减少了一半 (中位数为225与112.5MME,P<.001).
- 疼痛分数,包括最高和平均分数,在ERAS实施后显著降低 (P<.001).
结论:
- 包含药理和非药理方法的ERAS协议有效地管理剖腹产后的疼痛.
- 实施ERAS可以减少术后阿片类药物处方,减轻滥用和依赖的风险.
- 多模式疼痛疗法对于优化康复和减少在产科手术中的阿片类药物依赖至关重要.
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